Hyperuricemia is a risk factor for cardiovascular risk?

Background: Uric acid is the end product of purine metabolism in humans degraded by the hepatic enzyme, urate oxidase (uricase), to allantoin, which is freely excreted in the urine. However, during the Miocene epoch (20 to 5 million years ago), 2 parallel but distinct mutations occurred in early hominoids that rendered the uricase gene non-functional. Uric acid (UA) is a known endogenous scavenger, which provides a major part of the antioxidant capacity against oxidative and radical injury.Methods: The present study was conducted over a period of one year on outpatients attending the General Medicine Department at Narayana General Hospital, Nellore. The study was included 998 subjects (500 male and 498 female) and authors excluded other complications. Data were analyzed by SPSS software.Results: Serum uric acid of the subjects were measured. The mean and standard deviation were calculated for all the Biochemical parameter. The significance between the groups was determined using Student t-test for equality of means. The two-tailed P value is less than 0.0001, which is statistically significant. Confidence interval: the hypothetical mean is 1.0000 and the actual mean is 6.4600. The difference between these two values is 5.4600. The 95% confidence interval of this difference from 5.3489 to 5.5711. Intermediate values used in calculations; t = 96.4583, df = 999 and standard error of difference p = 0.057.Conclusions: About 53% of the subjects of the study are hyperuricemia, with about 74% of these subjects (or about 39% of the total) diagnosed with hypertension or diabetes mellitus or both, indicating a high CVD risk.

Comparative study of effectiveness of computer based knowledge in teaching versus conventional teaching perception in pharmacology among second year MBBS undergraduate medical students at Maharajah’s Institute of Medical Sciences, Andhra Pradesh, India

Background: Medical education has been asserted as one of the most challenging, demanding, and stressful fields of study, as medical students are expected to acquire diverse competencies such as academic, clinical, and interpersonal skills. Pharmacology is rapidly evolving and expanding conquering many diseases in its stride. The survey-based study we aim to grasp the MBBS students’ opinion regarding the teaching practices in pharmacology. Aim was to Study and compare the Effectiveness of Computer Based Teaching Versus Conventional Teaching Perception About Pharmacology Among Second Year MBBS Undergraduate Medical Students.Methods: A comparative study was conducted at Department of Pharmacology, Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram, Andhrapradesh. Two hundred second year MBBS medical students (n = 200) were divided into two groups.Results: In this study results shows P value and statistical significance the two-tailed P value is less than 0.0001 by conventional criteria, this difference is considered to be extremely statistically significant. Confidence interval the mean of Pre-test score minus Post test score equals -3.1900 and 95% confidence interval of this difference from -3.4503 to -2.9297.Conclusions: The importance of pharmacology in clinical decision making is well understood by the majority of students and they aim to act in that behest. Also, we find that computer based learning is a new and important tool coming up in the arsenal of the pharmacology teacher.

Serum gamma glutamyl transferase levels in association with lipids and lipoproteins in type2 diabetes mellitus.

Background: Serum gamma glutamyl transferase is widely used as a marker for alcohol induced liver disease. Recently it has gained importance due to its role in type2 diabetes mellitus. A raised serum gamma glutamyl transferase level indicates hepatic steatosis and visceral fat deposition, leading to insulin resistance and diabetes. In the present study we examined the association between serum gamma glutamyl transferase levels with lipids and lipoproteins in diabetes mellitus. Methods: The study was carried out on 50 subjects with type 2 diabetes mellitus and compared with 50 age and sex matched healthy controls attending outpatient department of general medicine, Narayana medical college, Nellore. Serum gamma glutamyl transferase was measured by calorimetric kinetic assay. Fasting blood sugar was measured by glucose oxidase method using automated analyzer. Serum triglycerides, total cholesterol and high density lipoprotein are measured by standard enzymatic procedures and low density lipoprotein by Friedwald equation. Results: Serum gamma glutamyl transferase levels in diabetic cases were significantly elevated compared to normal healthy controls (P <0.001). There was a positive correlation between gamma glutamyl transferase, lipids and low density lipoprotein and inverse correlation with high density lipoprotein (r = -0.298). Conclusion: Our results suggest a possible role of gamma glutamyl transferase in the pathophysiology and progression of type 2 diabetes mellitus.

Study of insulin resistance and antioxidant vitamin status in prostate cancer patients.

The incidence of prostate cancer is 5 per 100000 in southern and eastern Asia. Both genetic and environmental factors have been implicated in its etiology. The mitogenic and growth stimulatory effects of Insulin growth factor may be involved in prostate carcinogenesis. To evaluate serum insulin and insulin resistance was passed by HOMA- IR. Prostatic specific antigen passed by immune-enzymatic assay. Vitamins were estimated by high performance liquid chromatography. In our study 30 prostate cancer patients aged 60-80years were taken as cases. 30 normal age matched disease free person were taken as controls in both groups, Insulin resistance and antioxidant vitamin status was studied. In the present study, the value of HOMA-IR was (P <0.05) is significantly higher compare to controls. Serum vitamin E and vitamin C values for cases was reduced (P <0.05) significantly lower than controls. The development of prostate cancer is a multistep process. Hyperinsulinemia associated with insulin resistance may play a role in pathogenesis of prostate cancer. Prostate cancer cells generate high levels a ROS.

A comparative biochemical study on the non diabetic obese and non obese subjects with cardiovascular disease.

Cardiovascular disease is now a major public health problem in India and is emerging as a major killer. The non diabetic obese and non obese subjects with cardio vascular disease” were carried out with the objective of studying or investing the (effect) cause of cardiovascular diseases in obese and Non-obese subjects. The level of lipoprotein a of non obese subject showed a significant (P < 0.001) increase than in the obese subject. The level of lipid ratio (total cholesterol / HDL cholesterol) found to be significantly (P < 0.001) high in obese subjects than in non-obese subjects. The present study has been designed to evaluate or investigate the risk of cardiovascular disease due to obesity in both male and female middle age group.

Clonazepam induced maculopapular rash: a case report.

Clonazepam is a benzodiazepine with prominent anticonvulsant action than other members of the group at equisedating doses. It especially blocks pentylenetetrazole-induced seizures. Other important actions include anxiolysis. Common adverse effects to Clonazepam include drowsiness and lethargy. In this submission we report a case of Clonazepam induced maculopapular rash in a 30 year old female treated for panic disorder.

Decolourization of Selected Procion Dye Using Fungi, Acremonium Chrysogenum a Comparison with Physical Adsorbents.

Azo dyes, based on aromatic amines, may contain these amines as impurities introduced during the manufacturing process. Aromatic amines may also be present as a result of thermal or photochemical degradation of azo dyes. The more stable derivatives contain two aryl groups. As a consequence of п-delocalization, aryl azo compounds have vivid colors, especially reds, oranges, and yellows. Therefore, they are used as dyes, and are commonly known as azo dyes, an example of which is Disperse Orange. Some azo compounds, eg. methyl orange, are used as acid-base indicators due to the different colors of their acid and salt forms. The development of azo dyes was an important step in the development of the chemi azo colorants range in shade from greenish yellow to orange, red, violet and brown. The colours depend largely on the chemical constitution, whereas different shades rather depend on the physical properties. However, the important disadvantage limiting their commercial application is that most of them are red and none are green. The inoculum was prepared by adding 10ml of saline to the culture tube, which contain the Acremoniumchrysogenum. The present study designed to study the degradation of common laboratory dyes using fungi, acremonium chrysogenum. The dye selected was procion red. The selected dye procion red can be toxic in its secondary reactive form so there is a great need of them to be removed from the environment.

Efficacy and tolerability of trandolapril in mild to moderate hypertension--a double blind comparative clinical trial with enalapril in Indian population.

Several large scale clinical trials have demonstrated that angiotensin converting enzyme inhibitors offer cardiovascular and renal protection independent of their effects on systolic BP. Trandolapril is a new angiotensin converting enzyme inhibitor approved for the treatment of hypertension. The potential advantages of this drug are long duration of action and better tolerability. The objective of the study was to compare the efficacy and tolerability of trandolapril with that of enalapril in mild to moderate hypertension in Indian population. In this double blind, multicentric, parallel comparative clinical study, 120 patients with mild to moderate hypertension were randomly assigned to receive trandolapril 2 mg or enalapril 5 mg once daily for 8 weeks. The attainment of sitting diastolic blood pressure <90 mmHg at the end of 8th week was considered as primary outcome measure and attainment of diastolic blood pressure <90 mmHg or reduction of at least 10 mmHg diastolic blood pressure compared to baseline at any visit was considered as secondary outcome measures. 98.4% patients treated with trandolapril and 92.6% patients treated with enalapril fulfilled the primary outcome measure. 54, 72 and 62% patients on trandolapril and 52, 61 & 64% patients on enalapril fulfilled secondary outcome measure at the end of 2nd, 4th and 8th week respectively. Also trandolapril was better tolerated than enalapril with no significant abnormality in lab parameters.

A study of hypoglycemic and antioxidant activity of Aegle marmelos in alloxan induced diabetic rats.

The present study was performed to evaluate the hypoglycemic and antioxidant effect of aqueous extract of Aegle marmelos leaves (AML) on diabetic rats. Male albino rats were randomly divided into three groups: Group I: Control; Group II: Diabetic rats; and Group III: Diabetic rats administered AML. Glucose, urea and glutathione-S-transferase (GST) in plasma, glutathione (GSH) and malondialdehyde (MDA) levels in erythrocytes were estimated in all the groups at the end of four weeks. There was a decrease in blood glucose at the end of four weeks in group III animals compared with group II, however it did not reach the control levels. There was an increase in erythrocyte GSH and a decrease in MDA in group III as compared to group II. The plasma GST levels were raised in diabetic rats when compared to controls. In the group III animals, there was a decrease in GST as compared to group II. Owing to hypoglycemic and antioxidant properties, AML may be useful in the long-term management of diabetes.

Protective effect of Gingko biloba extract against doxorubicin-induced cardiotoxicity in mice.

Doxorubicin (DXR) causes dose dependent cardiotoxicity in experimental animals and in humans. In chronic doxorubicin cardiotoxicity model mice, the role of G. biloba extract (Gbe) which has an antioxidant property, was investigated. Doxorubicin treated animals showed higher mortality (68%), increased ascites, marked bradycardia, prolongation of ST and QT intervals and widening of QRS complex. Myocardial SOD and glutathione peroxidase activity were decreased and lipid peroxidation was increased. Ultrastructure of heart of DXR treated animals showed loss of myofibrils, swelling of mitochondria, vacuolization of mitochondria. G. biloba extract significantly protected the mice from cardiotoxic effects of doxorubicin as evidenced by lowered mortality, ascites, myocardial lipid peroxidation, normalization of antioxidant enzymes, reversal of ECG changes and minimal ultrastructural damage of the heart. The results indicate that administration of G. biloba extract protected mice from doxorubicin-induced cardiotoxicity.

Screening of Bacillus thuringiensis serotypes by polymerase chain reaction (PCR) for insecticidal crystal genes toxic against coffee berry borer.

Using PCR,257 isolates of Bacillus thuringiensis(Bt) were screened for cry-type genes. Of 257 isolates/strains, 60 isolates were identified as cry7/8, 10 isolates as cry3 and 36 isolates as cry 1I. One specific strain of B. thuringiensis (sumiyoshiensis; T03B 001) was investigated for the presence of cry7 and cry8 genes. Genes Cry7 and cry8 were first detected in this strain using family primers prior to analysis by exclusion polymerase chain reaction (E-PCR) using specific type primers. E-PCR conducted with the above said primers led to the identification by agarose gel electrophoresis of a remaining 1.5 Kb family band indicating a potentially novel gene. This PCR product, (1.5 Kb), was purified from the gel and cloned in pGEM-T Easy vector. Twenty recombinant colonies bearing 1.5 Kb insert were identified and three randomly selected representatives of the group, clones 7, 8 and 10, were sequenced and compared to all cry7 and cry8 sequences available from Gene Bank. Alignments with available DNA and protein sequences showed that all these clones contained a gene related to cry8Aa1. Analysis using protein sequence alignment showed that the sequence from clone 7 differed from the closest relative, known under the new nomenclature as cry 8Aa1, by 44%. The crystal proteins from B. thuringiensis sumiyoshiensis (T03B 001) was toxic to coffee berry borer larvae.

Pleomorphic xanthoastrocytoma--a clinicopathological study.

Six cases of Pleomorphic Xanthoastrocytoma of central nervous system are presented. One case presented with recurrent refractory seizures and others as intracranial space occupying lesions. They were located in temporal/parietal lobes, were partly cystic and partly solid on CT scan, enhancing with contrast. Histopathology was characterized by pleomorphic giant cells and cells with vacuolated cytoplasm. Glial fibrillary acidic protein was strongly positive in all the cases.

Effect of pentoxifylline on cyclosporine-induced nephrotoxicity in rats.

Effect of unique hemorrheologic agent pentoxifylline (PTX) was investigated on cyclosporine (CsA) induced nephrotoxicity in rats. Compared to saline control, CsA produced significant increase in blood urea and serum creatinine. Pentoxifylline treatment prevented the CsA-induced rise in blood urea and serum creatinine. Creatinine clearance (Ccr) and lithium clearance (Licr) was decreased with CsA. PTX treatment prevented the CsA-induced decrease in Ccr and Licr. Malondialdehyde (MDA) was increased with CsA compared to saline treated animals. PTX prevented the CsA-induced MDA rise. Kidney form CsA treated rat showed marked vacuolar degeneration of tubular epithelium with excess of microcalcification. Severity of the lesions was markedly reduced in rats treated with PTX plus CsA. The results indicate that PTX reduces CsA-induced renal toxicity in rats.

Drug Utilization in Geriatric Population im a Tertiary.

One hundred and fi fty-two prescriptions of patients aged more than 65 years were picked up from in-patients of ollr hospital and analysed for drug utilization pattern. The mean age of the patients was 69.9 ±5.7 years. The mean number of drugs per prescription were 6.33 ± 2.35. Tablets were used in 48.5%, injections in 39.6%, capsules and syrups in 5.5% each and inhalers in 1.1% of patients. Antibiotics were prescribed for 140 patients, diuretics for 34, ACE inhibitors for 33, Calcium channel blockers for 59, H2 blockers for 84, narcotic analgesics and NSAlDs for 36 and 33 patients respectively. Beta blocker usage was minimal. Digoxin, aspirin and thrombolytics were used in 10, 50 and 5 patients respectively. Compliance was 100% and side effects Iike haemoptysis, gastritis, palpitation and vomiting were seen in I patient each.

Immunomodulation of macrophages by radio-detoxified lipopolysaccharide of Salmonella typhimurium.

Lipopolysaccharide (LPS) and ratio-detoxified LPS (Rd-LPS) from Salmonella typhimurium were analysed for their ability to stimulate murine peritoneal exudate cells (PEC) and macrophages. Rd-LPS induced much more inflammatory response as compared to LPS. PEC numbers/mouse obtained were significantly higher (3-fold) in response to Rd-LPS than LPS. The haemorrhage was induced in mice by LPS but not by Rd-LPS. Activation of macrophages in vivo by Rd-LPS was significantly higher as compared to LPS. This was evident from the increase levels of their lysosomal enzymes and cytokines. Rd-LPS induced 10-fold increase in acid phosphatase contents of macrophages as compared to controls while only 7-fold increase was obtained with LPS. Arylsulfatase and beta-glucuronidase increased by about 2-fold by Rd-LPS and LPS. Macrophages incubated with Rd-LPS in vitro showed 16-fold and 20-fold increase in the cell associated levels of arylsulfatase and beta-glucuronidase respectively as compared to unstimulated cells. On the other hand, only 6-fold increase was observed in response to LPS in the levels of both the enzymes. TNF-[symbol: see text] and IL-1 secreted by macrophages increased considerably in response to Rd-LPS as compared to those released by LPS. Rd-LPS, thus seems to be a better immunomodulator than untreated LPS.

Cardioprotective effect of magnesium chloride in experimental acute myocardial infarction.

Cardioprotective role of intravenous administration of magnesium chloride was evaluated in rabbits by biochemical and histopathological parameters. Myocardial damage was induced by injecting (i.v.) isoprenaline 1, 2.5, 5 and 7.5 mg/kg body weight of animal. There was a dose dependent increase in the activity of cardiac enzyme creatinine kinase CK (C Max). Maximal elevation of CK (C Max) was observed with 2.5 mg isoprenaline. The mean T-max (mean of the time duration in hr at which maximum creatinine kinase activity of individual rabbit was observed in a group) shifted early, significantly with 2.5, 5 and 7.5 mg isoprenaline compared to control group. Histopathologically, myocardial damage was quite significant in 2.5 mg isoprenaline subgroup of animals. A mortality of 29% was observed in animals injected with 5 and 7.5 mg isoprenaline, whereas all animals subjected with 1 and 2.5 mg isoprenaline were alive for 72 hr. Considering the data on serial determination of cardiac enzyme CK and histopathological changes, 2.5 mg isoprenaline was chosen as standard dose to study efficacy of cardioprotection by gold standard verapamil and magnesium chloride. Verapamil (5 microM) injected prior to 2.5 mg isoprenaline administration revealed significant reduction of CK (C Max) activity (P < 0.05) compared to animals infused with isoprenaline alone. T-max value did not show any alteration in both the groups. Histopathological findings showed no areas of necrosis and cellular infiltrates in animals primed with 2.5 mg isoprenaline following verapamil. Highly significant reduction in CK (C-max) activity was observed in animals administered with 40 mg magnesium chloride prior to isoprenaline compared to animals treated with isoprenaline alone (P < 0.001). In addition to this, significant delay in T-max of CK activity was observed in group treated with 40 mg magnesium chloride and isoprenaline compared to group treated with only isoprenaline (P < 0.01). The study clearly highlighted and confirmed the valuable role of magnesium chloride as cardioprotective agent.

Effect of gamma irradiation on chemical and biological properties of lipopolysaccharide from Salmonella typhimurium.

Lipopolysaccharide (LPS) from S. typhimurium on exposure to gamma-radiation resulted in decrease in toxicity and was less mitogenic, Silver stained profiles of irradiated LPS on polyacrylamide gels revealed complete loss of its heteropolysaccharides which was confirmed further by analysing lipid A and LPS from Salmonella minnesota Re mutants on SDS-PAGE. Glucosamine and 2-keto 3-deoxy-octonate(Kdo) contents were significantly decreased on treatment. Lipid A obtained by removal of heteropolysaccharides from LPS was less toxic on exposure to gamma radiations.

Comparative study of omeprazole and famotidine in the treatment of duodenal ulcer.

In a double blind, multicenter, parallel group clinical trial in patients with symptomatic duodenal ulcers, 129 patients were randomized to receive either omeprazole 20 mg once daily (n = 65) or famotidine 40 mg once daily (n = 64) for 2 weeks, and if the ulcers were not healed, for a total of 4 weeks. Seventy four percent of these receiving omeprazole had healed ulcers after 2 weeks compared with 34.3% of those receiving famotidine (p < 0.001). At 4 weeks, the respective figures were 97.3% and 77.6% (p < 0.001). After 2 weeks of treatment, only 11.1% and 29.8% of omeprazole and famotidine treated patients respectively had day time pain (p < 0.02). Diary cards (successfully completed by 2/3rd of patients) showed that omeprazole treated patients required smaller amounts of antacids (p = ns). Over the first two weeks, ulcer healing rate was similar in smokers and non- smokers. No significant side effects were reported in either group. Omeprazole 20 mg/day provides more rapid relief of symptoms and heals a greater proportion of duodenal ulcers at 2 and 4 weeks than famotidine 40 mg/day.